New Uses for "Useless" Courses
New Uses for "Useless" Courses
Reality has a habit of surprising us at inopportune moments. I was on rounds for my general medicine rotation when the senior medical resident requested a thorough discussion of all toxic alcohols. The attending physician began sketching a chart on the board, drawing the chemical structures of methanol, ethanol, isopropyl alcohol, and ethylene glycol at the top of each column.
A look of abject horror appeared on each medical intern's face. One brave medical student pleaded with the doctor to write the name of the alcohol beside its corresponding chemical structure.
"If you can't decipher the basic composition of common household products, then I don't know why you're here."
Silence.
"Dan," the attending said to the chief resident, "since this is your topic, pick a student to name each chemical moiety."
We waited.
"How about the pharmacy student?"
Sure, pick the pharmacy student. On second thought, why not pick the pharmacy student?
I stumbled over to the dry-erase board, where I stared at all the carbon, hydrogen, and oxygen atoms along with their respective bonds, wishing the answers would magically appear. I managed to recall bits and pieces from a toxicology lecture: "Gasoline ingestion, APAP overdose, poisonous mushrooms..." What about the toxic alcohols? Why can't I remember their chemistry?
I then realized that we didn't review structures in toxicology class. I had to think back even farther, to a science class that focused on that 6th element on the periodic table. "Organic chemistry?" I thought, panicking. "That was so 2nd year!" I was determined not to whine to the medical team, though. I had to think fast. I finally recalled a little poem I had written 4 years earlier to remember the differences between the poisonous alcohols:
Antifreeze disliked numbers, it's true!
It Ceased 2Hate 6Or 2 (C2H6O2).
CH3OH is obviously methanol,
But sandwich in a CH2 and you've got ethanol.
CHOH between 2 methyl groups, subbing,
If you want isopropyl alcohol, rubbing.
That's it!
I turned to proudly face the resident. "C2H6O2 = ethylene glycol, CH3OH = methanol, CH3CH2OH = ethanol, and CH3CHOHCH3 = isopropyl alcohol."
"Excellent," he said. "This is material we all should have committed to memory ages ago. At least one of us has."
I had always considered my undergraduate classes a waste of time. Take physics, for example. The interactions of matter and energy have always been considered a nuisance by all pharmacy students who studied them. But one day, during a physiology lecture, I was amazed to hear this: "... This force is the difference in blood pressure (pressure gradient) across the vessel length or across the valve (P1-P2). At any given pressure gradient (P), the actual flow rate is determined by the resistance (R) to that flow..." I was forced to review the fundamental laws of physics in order to comprehend the mechanical, physical, and biochemical functions of living organisms. I began to see that, without physiology, pharmacology could not exist. And, if a pharmacist-to-be can't understand how drugs work, well ... that's a problem.
Then biochemistry rolled along. My initial feelings? "Lipolysis, Kreb's cycle, glycolysis, gluconeogenesis, blah, blah, blah." However, I soon had to reconsider that dismissive evaluation. During my clerkship at a busy retail pharmacy, a patient asked me if the Atkins diet was safe. I only knew that there wasn't enough data to support or disprove the fatty meal plan, so that was the answer I provided. I was then asked to clarify how lard-filled foods could possibly melt away pounds.
Was I able to explain it by myself to the patient? Not so much. After dusting off and paging through a book that discussed the structures and physical properties of biological molecules, I was finally able to give her the details in patient-friendly terminology. During this process, however, the pharmacy became backed up with customers waiting for help. I had held others up because I didn't know something that I should have known.
That same year, I was introduced to the world of biostatistics. I didn't care about the null hypothesis, P values, or the chi-square test. Only during my 2nd professional year of training, when "Biomedical Literature Evaluation" was a required class, did I realize how crucial it was for me to learn the basics of stats. The purpose of that class was to learn how to analyze clinical experiments, including the detailed evaluation of statistical studies.
Most 6th-year rotations also tested my statistical knowledge frequently by requiring me to dissect clinical trials. Because I had engrossed myself in probability theories during my 4th year, I was able to describe standard deviations and linear regressions with ease during 6th-year clerkship journal club sessions. I didn't have to hope that the preceptor wouldn't call on me to describe primary and secondary endpoints, or ask whether the statistical tests performed were appropriate. I answered most questions and even provided the clinical outcomes with confidence.
I thought I had forgotten many of my 2nd- and 3rd-year classes as soon as I passed them. But, as I moved through clinical rotations, I began to realize that the entire pharmacy curriculum was important, even those supposedly "useless" courses. Each one has turned out to be a powerful tool, so long as I know how to apply them.
Editor's Note: Elizabeth Thomas is a 2005 graduate of the University of the Sciences in Philadelphia, Pennsylvania. She is the first contributor to our new series on pharmacy training. Other contributions are invited from students, faculty, and practicing pharmacists who wish to reflect on topics related to pharmacy education. Submit essays to the Pharmacists Editor .
Reality has a habit of surprising us at inopportune moments. I was on rounds for my general medicine rotation when the senior medical resident requested a thorough discussion of all toxic alcohols. The attending physician began sketching a chart on the board, drawing the chemical structures of methanol, ethanol, isopropyl alcohol, and ethylene glycol at the top of each column.
A look of abject horror appeared on each medical intern's face. One brave medical student pleaded with the doctor to write the name of the alcohol beside its corresponding chemical structure.
"If you can't decipher the basic composition of common household products, then I don't know why you're here."
Silence.
"Dan," the attending said to the chief resident, "since this is your topic, pick a student to name each chemical moiety."
We waited.
"How about the pharmacy student?"
Sure, pick the pharmacy student. On second thought, why not pick the pharmacy student?
I stumbled over to the dry-erase board, where I stared at all the carbon, hydrogen, and oxygen atoms along with their respective bonds, wishing the answers would magically appear. I managed to recall bits and pieces from a toxicology lecture: "Gasoline ingestion, APAP overdose, poisonous mushrooms..." What about the toxic alcohols? Why can't I remember their chemistry?
I then realized that we didn't review structures in toxicology class. I had to think back even farther, to a science class that focused on that 6th element on the periodic table. "Organic chemistry?" I thought, panicking. "That was so 2nd year!" I was determined not to whine to the medical team, though. I had to think fast. I finally recalled a little poem I had written 4 years earlier to remember the differences between the poisonous alcohols:
Antifreeze disliked numbers, it's true!
It Ceased 2Hate 6Or 2 (C2H6O2).
CH3OH is obviously methanol,
But sandwich in a CH2 and you've got ethanol.
CHOH between 2 methyl groups, subbing,
If you want isopropyl alcohol, rubbing.
That's it!
I turned to proudly face the resident. "C2H6O2 = ethylene glycol, CH3OH = methanol, CH3CH2OH = ethanol, and CH3CHOHCH3 = isopropyl alcohol."
"Excellent," he said. "This is material we all should have committed to memory ages ago. At least one of us has."
I had always considered my undergraduate classes a waste of time. Take physics, for example. The interactions of matter and energy have always been considered a nuisance by all pharmacy students who studied them. But one day, during a physiology lecture, I was amazed to hear this: "... This force is the difference in blood pressure (pressure gradient) across the vessel length or across the valve (P1-P2). At any given pressure gradient (P), the actual flow rate is determined by the resistance (R) to that flow..." I was forced to review the fundamental laws of physics in order to comprehend the mechanical, physical, and biochemical functions of living organisms. I began to see that, without physiology, pharmacology could not exist. And, if a pharmacist-to-be can't understand how drugs work, well ... that's a problem.
Then biochemistry rolled along. My initial feelings? "Lipolysis, Kreb's cycle, glycolysis, gluconeogenesis, blah, blah, blah." However, I soon had to reconsider that dismissive evaluation. During my clerkship at a busy retail pharmacy, a patient asked me if the Atkins diet was safe. I only knew that there wasn't enough data to support or disprove the fatty meal plan, so that was the answer I provided. I was then asked to clarify how lard-filled foods could possibly melt away pounds.
Was I able to explain it by myself to the patient? Not so much. After dusting off and paging through a book that discussed the structures and physical properties of biological molecules, I was finally able to give her the details in patient-friendly terminology. During this process, however, the pharmacy became backed up with customers waiting for help. I had held others up because I didn't know something that I should have known.
That same year, I was introduced to the world of biostatistics. I didn't care about the null hypothesis, P values, or the chi-square test. Only during my 2nd professional year of training, when "Biomedical Literature Evaluation" was a required class, did I realize how crucial it was for me to learn the basics of stats. The purpose of that class was to learn how to analyze clinical experiments, including the detailed evaluation of statistical studies.
Most 6th-year rotations also tested my statistical knowledge frequently by requiring me to dissect clinical trials. Because I had engrossed myself in probability theories during my 4th year, I was able to describe standard deviations and linear regressions with ease during 6th-year clerkship journal club sessions. I didn't have to hope that the preceptor wouldn't call on me to describe primary and secondary endpoints, or ask whether the statistical tests performed were appropriate. I answered most questions and even provided the clinical outcomes with confidence.
I thought I had forgotten many of my 2nd- and 3rd-year classes as soon as I passed them. But, as I moved through clinical rotations, I began to realize that the entire pharmacy curriculum was important, even those supposedly "useless" courses. Each one has turned out to be a powerful tool, so long as I know how to apply them.
Editor's Note: Elizabeth Thomas is a 2005 graduate of the University of the Sciences in Philadelphia, Pennsylvania. She is the first contributor to our new series on pharmacy training. Other contributions are invited from students, faculty, and practicing pharmacists who wish to reflect on topics related to pharmacy education. Submit essays to the Pharmacists Editor .
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